Organization
MICHIGAN INSTITUTE OF UROLOGY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALPHONSE M SANTINO MD (PRESIDENT)
(586) 771-4820
Entity
Organization
Contact information
Practice address
14800 FARMINGTON RD, SUITE 103, LIVONIA, MI 48154-5461
(734) 261-7401
(734) 261-7417
Mailing address
20952 E 12 MILE RD, SUITE 200, SAINT CLAIR SHORES, MI 48081-3200
(586) 771-4820
(586) 771-6620
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0E06273
BCBSM
MI
01
—
CB9133
RAILROAD MEDICARE
MI
Enumeration date
10/04/2006
Last updated
03/11/2011
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